Accounts Receivable Specialist

Job Summary
Job Title

OBGYN Accounts Receivable (AR) & Denial Management Specialist

Location

Illinois | Onsite

Position Summary

We are an established OBGYN practice seeking an experienced AR & Denial Management Specialist with strong hands-on expertise in OBGYN billing, payer follow-up, and appeals. This role is heavily focused on insurance AR resolution, denial analysis, and revenue recovery.

Key Responsibilities (Primary Focus – AR & Denials)

Insurance AR Management

• Manage and work insurance AR aging (30–120+ days) with a strong focus on timely resolution
• Perform detailed payer follow-up with commercial plans, Medicaid, and Medicare
• Identify root causes of unpaid and underpaid claims and take corrective action

Denial Analysis & Appeals

• Analyze denials related to OBGYN services, including but not limited to:
• Global OB care
• Prenatal and postpartum services
• Ultrasounds
• Mammogram
• NIPT and genetic testing
• Preventive vs diagnostic services
• Prepare and submit first-level and second-level appeals with supporting documentation
• Apply payer-specific policies, peer guidelines, and Illinois regulations to appeal strategy
• Track appeal outcomes and adjust workflows to reduce future denials

Coding & Compliance Support

• Review claims for accuracy using CPT, ICD-10, and modifier guidelines
• Ensure alignment with payer medical necessity, LCDs, and OB-specific billing rules
• Work closely with coding and front-end teams to prevent recurring issues

Secondary Responsibilities

• Handle patient billing inquiries related to statements and balances
• Clearly explain insurance adjustments, denials, and patient responsibility when needed
• Assist with Charge and ERA posting when needed
• Document all account activity thoroughly in the billing system

Required Qualifications

• 3+ years of hands-on AR and denial management experience in an OBGYN setting
• Strong working knowledge of CPT, ICD-10, modifiers, and OB-specific billing rules
• Proven experience with insurance follow-up and appeals
• Familiarity with Illinois payer policies, Medicaid, and commercial plans
• Ability to independently manage a high-volume AR worklist

Preferred Qualifications

• Experience with OB global billing, genetic testing, and ultrasound denials
• Strong understanding of payer medical policies and peer guidelines
• EHR and practice management system experience
• Excellent documentation and communication skills

Job Types: Full-time, Part-time

Work Location: In person

Pay: $21.00 - $24.00 per hour

Benefits:

• Health insurance
• Paid time off

Work Location: In person